1669424701 NPI number — MISSISSIPPI HEARING CENTER, INC

Table of content: (NPI 1669424701)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669424701 NPI number — MISSISSIPPI HEARING CENTER, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MISSISSIPPI HEARING CENTER, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1669424701
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1151 N STATE ST
Provider Second Line Business Mailing Address:
SUITE 107
Provider Business Mailing Address City Name:
JACKSON
Provider Business Mailing Address State Name:
MS
Provider Business Mailing Address Postal Code:
39202-2407
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
601-352-4613
Provider Business Mailing Address Fax Number:
601-969-1976

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1151 N STATE ST
Provider Second Line Business Practice Location Address:
SUITE 107
Provider Business Practice Location Address City Name:
JACKSON
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
39202-2407
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
601-352-4613
Provider Business Practice Location Address Fax Number:
601-969-1976
Provider Enumeration Date:
05/17/2006

Additional Information

Authorized Official

Authorized Official Last Name:
LOCKEY
Authorized Official First Name:
MYRON
Authorized Official Middle Name:
WILLIS
Authorized Official Title or Position:
PRESIDENT/OWNER
Authorized Official Telephone Number:
601-352-4613

Provider Taxonomy Codes

  • Taxonomy code: 235500000X , with the licence number:  04537 , registered in the state of MS ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 261QH0700X , with the licence number: 04537 , registered in the state of MS ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com